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PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave. , Third Floor, Stockton, CA 95202 <br /> (209) 468-3420 <br /> UNDERGROUND <br /> 7 STORAGE TANK /J(UST) PROGRAM INSPECTION REPORT <br /> Facility Name U15d aAb �j//3'1'1 (TIOProgram ID#Z3 1��9 <br /> Facility Address,2 ;3 16.Y)Sr� City 'toG -�r� Zip <br /> UST: Dual Wall Single Wall OVERF LL• Audible Visual Mechanical <br /> PIPING SYSTEM: Dual wall Single wall_;>< SuctionPressureGravity <br /> DOES THE LEAK DETECTION SYSTEM meet 23CCR 2636 (g) requirements. YES NO <br /> VIOLATIONS <br /> TANK # <br /> UST GENERAL REQUIREMENTS <br /> Permit to O ;rate [H&SC 252841 <br /> orms & B urrent LH&SC 25.28-4c) ] <br /> monitoring/maintenance Records 23CCR 2712 (b) ] <br /> Monitoring Records Available 23CCR 2712 <br /> Monitoring Plan 23CCR 2632 (d) (1) ] <br /> Unauthorized Releases Re orted [H&SC 252951 <br /> Monitoring Equipment Annua Cert. 23CCR 2b3UtaTT <br /> over spill on ainer <br /> Cathodic Protection 23CCR 2635 a 2 A <br /> New USTs Monitored Continuously [23CCR 2630] <br /> MANUAL INVENTORY RECONCILIATION (MIR) <br /> Meters Calibrated r23CCR 2646 (i) l <br /> Monthly Variations Calculated [23CCR 2646 (d) ] <br /> x- aria ion Procedure Followed L23CCR 2646 (e) j <br /> STATISTICAL INVENTORY RECONCILIATION (SIR) <br /> Inconclusive Procedure Followed [23CCR 2646.1 (d) ] <br /> UST Integrity Test Every Two Years 23CCR 2646.1 <br /> Annual SIR Report [23CCR 2646.1 (j) ] <br /> Daily Stick Reading L23CCR 2646 Tc77T7T-- <br /> GAUGING <br /> Monthly ATG Results [23CCR 2643 (b) (1) ] <br /> Annual Summary epor <br /> MANUAL UST TANK GAUGING (MTG) <br /> Tank Gauging Weekly [23CCR 2645 (b) ] <br /> Annual ank integrity Test <br /> uanx uaugingroc; ure L-'0110weu <br /> ONITORTNG <br /> Daily Suction Piping M <br /> Piping Tightness Test 123CCR 2643 b c d <br /> Gravit Pi in Tested Ever 2 Years [23CCR2643 (e) ] <br /> Mont y Line Test 23CCR 2643 c 2 <br /> TANK REMOVAL <br /> Permit to Close or Cease Operation H&SC 252-9-87- <br /> -Ke—moved, Closedor Temporar y C ose R 2670 <br /> RENS INSPECTION DATE/TYPE: lqi <br /> RECEIVED BY: PHONE: <br /> Revised Date 7/15/97 23 CCR UST Regs May 5, 1994 PAGE of <br /> PHS 280 (4/88) <br />